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GENESIS MEDICAL GROUP LLC
NPI 1013214014
Prosthetic/Orthotic Supplier in Portland, OR

Active since February 28, 2011
10802 SE WASHINGTON ST, PORTLAND, OR 97216(503) 699-1911(503) 699-1912 Get Directions Write a Review

NPPES record last updated: August 14, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Genesis Medical Group Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GENESIS MEDICAL GROUP LLC (NPI 1013214014) is a healthcare organization registered as a prosthetic/orthotic supplier in Portland, Oregon and active in the NPI registry since February 2011. The organization lists Wyatt James Brown, Director Of Operation, as its authorized official.

NPPES Registry Identity

NPI1013214014
Entity TypeOrganization
Primary Taxonomy335E00000X
Legal Business NameGENESIS MEDICAL GROUP LLC
Location Address10802 SE WASHINGTON STPortland, OR 97216-3118
Mailing Address16679 Boones Ferry Rd Ste 215Lake Oswego, OR 97035-4368 · (503) 699-1911 · Fax (503) 699-1912
Phone(503) 699-1911
Fax(503) 699-1912
Organization SubpartYesParent: Genesis Medical Group, Llc
Authorized OfficialWyatt James BrownDirector Of Operation · (503) 699-1911
Enumeration DateFebruary 28, 2011
Last NPPES UpdateAugust 14, 2012
✔ NPI 1013214014 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyProsthetic/Orthotic SupplierSuppliers
Taxonomy Code335E00000X
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
10802 SE WASHINGTON ST, Portland, OR 97216
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Other Identifiers 1

Medicaid500608071OR

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EAST PORTLAND PERITONEAL DIALYSIS CLINIC, LLC
Clinic/Center (End-Stage Renal Disease (ESRD) Treatment)
10802 SE WASHINGTON ST
PORTLAND, OR 97216
Multnomah County (503) 254-4426
GENESIS MEDICAL GROUP II, INC
Prosthetic/Orthotic Supplier
10802 SE WASHINGTON ST
PORTLAND, OR 97216
Multnomah County (503) 231-1529

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Genesis Medical Group LLC's NPI number?

The NPI number for Genesis Medical Group LLC is 1013214014. It was assigned to this organization in the NPPES registry on February 28, 2011.

Where is Genesis Medical Group LLC located?

Genesis Medical Group LLC is located at 10802 SE Washington St, Portland, OR 97216. The listed phone number is (503) 699-1911.

What is Genesis Medical Group LLC's specialty?

The primary specialty registered for this NPI is Prosthetic/Orthotic Supplier with taxonomy code 335E00000X.

When was this NPI record last updated?

The NPPES record for Genesis Medical Group LLC was last updated on August 14, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.